08 RoxiewellsCape Fear Valley Hoke Hospital is the only hospital in the region to have earned Geriatric Emergency Department accreditation by the American College of Emergency Physicians. Such certification recognizes hospitals that are focused on the highest standards of care for older adults. “Hoke Hospital has worked hard to earn this accreditation,” said Roxie Wells, M.D., Hoke Hospital President. “From our award-winning joint-replacement program to our stellar ICU unit, everything we do helps elevate the care of geriatric patients in our community.”

Hoke Hospital is located off U.S.401 just south of the Cumberland County line.

ACEP began accrediting geriatric emergency departments in 2018. To date, accreditation has been granted to fewer than 150 hospitals nationwide. The concept was developed by professionals in emergency medicine to ensure that older patients receive quality care because the complexity of care rises with age. Older patients are more likely to have conditions such as heart disorders and chronic obstructive pulmonary disease, or COPD. “Older patients don't want to be in the hospital,” Wells noted. “They may not see or hear as well, and they are more vulnerable to infection. The COVID-19 pandemic is of concern to us,” she added.


In the past, the tendency in emergency medicine was to admit older patients to the hospital out of an abundance of caution without regard to their special needs. Now, geriatric emergency departments incorporate specially trained staff, who assess older patients more comprehensively as they arrive in the E.R. and take steps to make the experience more comfortable and less intimidating. Everything about the E.R. experience can be challenging for older adults. Patients are often confused or disoriented. For those unsteady on their feet, navigating cramped quarters is difficult. For those who are alone without a friend or family member, it's frightening.

Having a geriatric E.D. does not mean creating a separate space for seniors, but rather using specific processes, which include screening for geriatric syndromes such as stroke. “Over 60% of hospital admissions for patients over the age of 65 come through the emergency department," said Dr. Kevin Biese, an emergency medicine physician with University of North Carolina Hospitals, who has a focus in geriatrics.

Clinical experts have developed the basic criteria for geriatric emergency departments and describe what patients and families should look for and expect. Patients who are on several prescribed medications might benefit from having their drug regimens trimmed.

Geriatric emergency departments are needed to fill substantial gaps in care for older adults, said Dr. Christopher Carpenter, an associate professor of emergency medicine with Washington University School of Medicine in St. Louis. "(There is) unprecedented growth in aging demographics — with 10,000 baby boomers turning 65 every day — yet the health care system is not adapting to address unique geriatric needs," said Carpenter, who is also deputy editor-in-chief of Academic Emergency Medicine and associate editor of the Journal of the American Geriatrics Society.

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